Retrospective study of clinic-epidemiological correlation between body mass index (BMI) and colorectal cancer (CRC) with survival impact.

BACKGROUND: Body mass index (BMI) is positively associated with the risk of colorectal cancer (CRC). For that reason, investigators have hypothesized that being overweight or obese leads to worse CRC prognosis and survival outcome. METHODOLOGY: The impact of BMI in patients with colorectal cancer on (disease free survival) DFS and three years overall survival (OS) rates in correlation with clinic-pathological data of those patients was studied on 128 patients enrolled in this study. They were diagnosed with stage II and III colorectal cancer that presented at clinical oncology department Ain Shams University hospitals from January 2016 till December 2017 with 3 years duration follow up. All of them had measured their BMI at time of presentation. RESULTS: Estimated 3- years OS for each BMI category revealed that normal weight patients had 97.1% survival rate and overweight patients had 77.8% survival rate. Much lower survival rates for both underweight and obese patients had been estimated being (33.3%, 37.3%) respectively. This correlation to BMI categories shows a statistically significant value between normal weight patients and overweight patients in relation to underweight and obese patients (p- value < 0.0001). CONCLUSION: BMI has an impact on colorectal cancer patients with clinicopathological relations and survival rate.

Induction chemotherapy with capecitabine and oxaliplatin followed by chemoradiotherapy before surgery in patients with locally advanced rectal cancer.

BACKGROUND: Locally advanced rectal cancer (LARC) has a high incidence of local and distant relapse even after adequate treatment. The emerging role of neoadjuvant induction chemotherapy may allow initial down staging of the primary tumor, less toxicity and early treatment of micrometastatic disease followed by chemoradiation with the hope of increased complete response rates before surgery OBJECTIVES: To identify the effect of induction chemotherapy before concurrent chemoradiation (CCRTH) in locally advanced rectal cancer in terms of response and toxicity. Primary end point is assessment of pathological complete response rate after surgery. Secondary end points are disease free survival (DFS) and overall survival (OS) after 3 years follow up. PATIENTS AND METHODS: Patients with MRI based criteria for staging high-risk LARC (T4 tumors, tumors within 2 mm of mesorectal fascia, T3 tumors at or below levators and T2-4 with LN +ve tumors) were included. Thirty-five patients were recruited. Patients received 12 weeks of induction capecitabine/oxaliplatin followed by concomitant capecitabine and conventional 3D-conformal radiotherapy. Surgery was done at least 6 weeks later . RESULTS: Five patients (20.8%) had a pathological complete response (TRG 0) (ypT0N0). Another three patients (12.5%) had near complete pathological response (TRG 1). Regarding OS and pathological complete response corrlelation, it was statistically not significant in relation to patients with incomplete pathological response (p = 1). CONCLUSION: Induction chemotherapy could be a promising option for better response rates either clinical or pathological for high risk LARC patients with acceptable toxicity.